Individual provider Active NPI

Patrick Ayres, O.D.

  • Optometrist
  • Bend, OR
National Provider Identifier
1639150873
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3188AT Issued in OR
Practice address
143 SW Shevlin-Hixon Dr, #101
Bend, OR 97702
Phone
(541) 317-9747
NPI assigned
Nov 7, 2005
Last updated
Mar 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3188AT OR Primary

Addresses

Primary practice location

143 SW Shevlin-Hixon Dr, #101
Bend, OR 97702

Mailing address

143 SW Shevlin-Hixon Dr, #101
Bend, OR 97702
Phone (541) 317-9747

Other identifiers 1

IdentifierTypeStateIssuer
278946MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080208000146 OR Practitioner - Optometry 8628151040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patrick Ayres, OD, PCGroup PAC ID 9234212655, 2 clinicians

Practice addresses (Care Compare)

143 SW Shevlin-Hixon Dr
101 Riverbend Eyecare
Bend, OR 97702-3189
Phone (541) 317-9747

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick Ayres, OD, PC Optometrist CurrentSince Jan 1, 2008 Accepting new patients

Locations

143 SW Shevlin Hixon Dr
Ste 101
Bend, OR 97702
Phone (541) 317-9747

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1639150873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SW SHEVLIN-HIXON DR, #101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-317-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 SW SHEVLIN-HIXON DR, #101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-317-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYRES",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3188AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278946",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.